Viread

Viread is a medication used to treat HIV infection and hepatitis B infections. This medication can cause a build-up of acid in the blood.

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Pharmacist Steve Lozano, PharmD summarizes the uses, common side effects, and warnings for the NRTIs class of medications

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NRTIs

Pharmacist Steve Lozano, PharmD summarizes the uses, common side effects, and warnings for the NRTIs class of medications

Antivirals

Pharmacist Steve Lozano, PharmD summarizes the uses, common side effects, and warnings for the Antivirals class of medications

Viread Overview

Updated: July 21, 2015

Viread is a prescription medication used along with other medications to treat human immunodeficiency virus (HIV) and hepatitis B infections. Viread belongs to a group of drugs called nucleoside reverse transcriptase inhibitors (NRTIs) which work by stopping the virus from replicating.

This medication comes in tablet form and in an oral powder to be mixed with soft food that does not require chewing (applesauce). Viread is taken once daily. Viread tablets can be taken with or without food.

Viread Interactions

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Viread may affect the way other medicines work, and other medicines may affect how Viread works.

Do not take Viread if you also take:

other medicines that contain tenofovir such as Atripla, Complera, and Truvada

Viread Precautions

1. Build-up of an acid in your blood (lactic acidosis). Lactic acidosis can happen in some people who take Viread. Lactic acidosis is a serious medical emergency that can lead to death.

Lactic acidosis can be hard to identify early, because the symptoms could seem like symptoms of other health problems. Call your healthcare provider right away if you get the following symptoms which could be signs of lactic acidosis:

feeling very weak or tired

have unusual (not normal) muscle pain

have trouble breathing

have stomach pain with

nausea (feel sick to your stomach)

vomiting

feel cold, especially in your arms and legs

feel dizzy or lightheaded

have a fast or irregular heartbeat

2. Severe liver problems. Severe liver problems can happen in people who take Viread. In some cases these liver problems can lead to death. Your liver may become large (hepatomegaly) and you may develop fat in your liver (steatosis) when you take Viread.

Call your healthcare provider right away if you have any of the following symptoms of liver problems:

Your skin or the white part of your eyes turns yellow (jaundice).

dark "tea-colored" urine

light-colored bowel movements (stools)

loss of appetite for several days or longer

nausea

stomach pain

You may be more likely to get lactic acidosis or severe liver problems if you are female, very overweight (obese), or have been taking Viread for a long time.

New or worse kidney problems can happen in some people who take Viread . If you have had kidney problems in the past or need to take another medicine that can cause kidney problems, your healthcare provider may need to do blood tests to check your kidneys during your treatment with Viread.

Bone problems can happen in some people who take Viread. Bone problems include bone pain, softening or thinning (which may lead to fractures). Your healthcare provider may need to do additional tests to check your bones.

Changes in body fat can happen in some people who take antiviral medicines. These changes may include increased amount of fat in the upper back and neck ("buffalo hump"), breast, and around the main part of your body (trunk). Loss of fat from the legs, arms, and face may also happen. The cause and long-term health effects of these conditions are not known.

Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider if you start having new symptoms after starting your HIV medicine.

3. Worsening of your Hepatitis B infection. Your hepatitis B Virus (HBV) infection may become worse (flare-up) if you take Viread and then stop it. A "flare-up" is when your HBV infection suddenly returns in a worse way than before.

Do not let your Viread run out. Refill your prescription or talk to your healthcare provider before your Viread is all gone.

Do not stop taking Viread without first talking to your healthcare provider.

If you stop taking Viread, your healthcare provider will need to check your health often and do blood tests regularly to check your HBV infection. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking Viread.

Talk to your doctor about taking an HIV test before starting treatment with Viread for chronic hepatitis B. You should also get a test for HBV if you are taking Viread for treatment of HIV.

Viread Food Interactions

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Viread, there are no specific foods that you must exclude from your diet when receiving Viread.

are pregnant or plan to become pregnant. It is not known if Viread will harm your unborn baby.

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Viread may affect the way other medicines work, and other medicines may affect how Viread works.

Viread and Pregnancy

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category B. It is not known if Viread will harm your unborn baby. There is a pregnancy registry for women who take antiviral medicines during pregnancy. Its purpose is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry.

Viread and Lactation

Do not breastfeed if you are taking Viread. Viread passes into your breast milk. You should not breastfeed because of the risk of passing HIV to your baby. Talk to your healthcare provider about the best way to feed your baby.

Do not miss a dose of Viread. If you miss a dose of Viread, take the missed dose as soon as you remember. If it is almost time for your next dose of Viread, do not take the missed dose. Take the next dose of Viread at your regular time.

If you take too much Viread, call your local poison control center or go right away to the nearest hospital emergency room.

Preparation of Viread powder:

Wash and dry your hands.

Measure ¼ to ½ cup of soft food into a cup or bowl.

To open a new bottle of powder, press down on the bottle lid and turn to remove (see picture on the top of the bottle cap). Peel off the foil.

Measure the number of scoops prescribed by your healthcare provider.

For each full scoop prescribed:

Fill the dosing scoop to the top.

Use the flat edge of clean knife to make the powder even with the top of the scoop

For ½ scoop:

Fill the dosing scoop up to the "½ line" on the side

Sprinkle the Viread oral powder on the soft food. Stir with a spoon until well mixed. Give the entire dose right away after mixing to avoid a bad taste.

Close the bottle of Viread tightly.

Wash and dry the dosing scoop. Do not store the dosing scoop in the bottle.

Viread Dosage

Take Viread exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Recommended Dose in Adults

For the treatment of HIV-1 or chronic hepatitis B: The dose is one 300 mg Viread tablet once daily taken orally, without regard to food.

For adults unable to swallow Viread tablets, the oral powder formulation (7.5 scoops) may be used.

In the treatment of chronic hepatitis B, the optimal duration of treatment is unknown.

Recommended Dose in Pediatric Patients (2 to Less Than 18 Years of Age)

For the treatment of HIV-1 in pediatric patients 2 years of age and older, the recommended oral dose of Viread is 8 mg of Viread disoproxil fumarate per kilogram of body weight (up to a maximum of 300 mg) once daily administered as oral powder or tablets.

Viread oral powder should be measured only with the supplied dosing scoop. One level scoop delivers 1 g of powder which contains 40 mg of Viread disoproxil fumarate. Viread oral powder should be mixed in a container with 2 to 4 ounces of soft food not requiring chewing (e.g., applesauce, baby food, yogurt). The entire mixture should be ingested immediately to avoid a bitter taste. Do not administer Viread oral powder in a liquid as the powder may float on top of the liquid even after stirring. Further patient instructions on how to administer Viread oral powder with the supplied dosing scoop are provided in the FDA-approved patient labeling (Patient Information).

Viread is also available as tablets in 150, 200, 250 and 300 mg strengths for pediatric patients who weigh greater than or equal to 17 kg and who are able to reliably swallow intact tablets. The dose is one tablet once daily taken orally, without regard to food. Weight should be monitored periodically and the Viread dose adjusted accordingly.

Viread FDA Warning

Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogs, including Viread, in combination with other antiretrovirals.

Severe acute exacerbations of hepatitis have been reported in HBV-infected patients who have discontinued anti-hepatitis B therapy, including Viread. Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in patients who discontinue anti-hepatitis B therapy, including Viread. If appropriate, resumption of anti-hepatitis B therapy may be warranted.

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